Distal humerus nonunion after failed internal fixation: reconstruction with total elbow arthroplasty

In nonunion after distal humerus fracture, osteoporosis, devascularized fracture fragments, and periarticular fibrosis limit potential reconstructive options. We assessed pain relief, functional gains, and complications in 12 patients whose long-standing, painful nonunions after previous treatment w...

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Bibliographic Details
Published inThe American journal of orthopedics (Belle Mead, N.J.) Vol. 37; no. 10; p. 531
Main Authors LaPorte, Dawn M, Murphy, Michael S, Moore, J Russell
Format Journal Article
LanguageEnglish
Published United States 01.10.2008
Subjects
Adult
Aged
Arthroplasty
Elbow Joint - diagnostic imaging
Elbow Joint - surgery
Female
Fracture Fixation, Internal - methods
Fractures, Ununited - surgery
Humans
Humeral Fractures - surgery
Male
Middle Aged
Radiography
Retrospective Studies
Treatment Failure
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Summary:In nonunion after distal humerus fracture, osteoporosis, devascularized fracture fragments, and periarticular fibrosis limit potential reconstructive options. We assessed pain relief, functional gains, and complications in 12 patients whose long-standing, painful nonunions after previous treatment with rigid internal fixation were reconstructed with a semiconstrained total elbow arthroplasty, frequently with a triceps-sparing approach and anterior ulnar nerve transposition. At mean follow-up of 63 months, 11 patients had good pain relief and a good or excellent functional result: mean flexion/extension, 134 degrees to 18 degrees; mean total arc of motion, 117 degrees ; mean pronation/supination, 74 degrees to 69 degrees. Despite the 75% rate of complications (8), semiconstrained total elbow arthroplasty provides a viable treatment for this difficult problem.
ISSN:1934-3418